Enabling Dwelling: Caregiving and Familiar Object Interactions amidst Cognitive Decline in Rural South Africa Michelle Brear,1,2,3 Themby Nkovana,1 Lenore Manderson2,4 michelle.brear@wits.ac.za 1 MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa 2 School of Public Health, University of the Witwatersrand, Johannesburg, South Africa 3 School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia 4 School of Social Sciences, Monash University, Melbourne, Australia Abstract As people experience cognitive decline, they make and remake their identities in practice, including through interactions with everyday objects. Facilitating object interactions thus becomes an act of care. We present ethnographic data detailing how two women with cognitive decline, who were receiving informal home-based care in a rural area of South Africa, shaped and expressed their identities by dwelling — using objects to enact practices through which they formed binding relationships— and how dwelling built on and shaped their identities and relationships. Both women interacted with objects related to domestic and agricultural work — homegrown fruit, water, firewood, brooms — in ways that reflected their cultural, class and gender identities as homemakers and through which they made their homes homely. The women navigated domestic spaces with a familiarity that revealed their sense of belonging. Yet caregivers sometimes restricted their access to objects that facilitated mental health promoting practices, due to scarcity. We suggest a need to understand the social benefits of “aging in place” (at home) in relation to the opportunities that places — potentially extending to institutional care facilities — afford for dwelling. Narratives advocating aging in place must acknowledge the cultural and personal continuity, as well as the material deprivations and related restrictions, that aging at home in precarious circumstances entails, for people with cognitive decline and for their caregivers. Keywords: Aging in place; Dementia; Home-based care; Materiality Anthropology & Aging, Vol 46, No 1 (2025), pp. 1-15 ISSN 2374-2267(online) DOI 10.5195/aa.2025.544 This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License. This work is published by Pitt Open Library Publishing. https://library.pitt.edu/e-journals http://creativecommons.org/licenses/by-nc-nd/3.0/us/ Brear, Nkovana, and Manderson | 1 Vol 46 No 1 (2025) ISSN 2374-2267 (online) DOI 10.5195/aa.2025.544 http://anthro-age.pitt.edu Enabling Dwelling: Caregiving and Familiar Object Interactions amidst Cognitive Decline in Rural South Africa Michelle Brear,1,2,3 Themby Nkovana,1 Lenore Manderson2,4 michelle.brear@wits.ac.za 1 MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa 2 School of Public Health, University of the Witwatersrand, Johannesburg, South Africa 3 School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia 4 School of Social Sciences, Monash University, Melbourne, Australia Rhandzu came with a jug which she poured water onto our hands from. She took the jug back inside and returned with a towel which she passed me to wipe my hands with. (Fieldnote; December 13, 2022) Rhandzu joined us on the couch … and immediately demanded mahinyahinya, a Shangaan term that refers to nice food. She clearly expected her sister to serve it. (Fieldnote; January 25, 2023) Introduction Interactions with everyday objects enable people with memory problems, such as those that characterize dementia, to identify themselves in different ways. For example, by pouring water from a jug and providing a towel on which a visitor can dry their hands, a woman with memory problems such as Rhandzu, a 72-year-old living in rural South Africa, can also perform the gendered identity of caregiver. Alternatively, by waiting for another to prepare and serve her food, she can perform the role of care recipient. Interacting with familiar objects in these ways can extend relations, and create a sense of homeliness, that is, make people feel “at home” (Latimer and Munro 2009). Knowledge of how interactions with everyday objects shape identity in people with memory problems or cognitive decline (terms we use interchangeably throughout the article), in ways that influence their health and quality of life, comes primarily from studies in institutional, long-term care settings in high-income countries (Cruise and Lashewicz 2022). In this article, we explore interactions with familiar objects of two women living in an economically marginalized rural area of South Africa, a highly unequal, middle-income country. Neither had been diagnosed with dementia, but both were receiving informal, home-based care as a result of their memory loss and symptoms consistent with cognitive decline. Our aim is to explore how these two women shaped and expressed their identities through interactions with everyday objects. Literature Review Dementia is a set of symptoms resulting from cognitive decline, the incremental loss of ability to remember, communicate, think, and reason. It is caused by numerous conditions that affect the brain, most commonly Alzheimer’s disease, the risk of which is strongly associated with aging; it is considered “young onset” when it affects people under 65 years of age (Alzheimer's Association 2025). The http://anthro-age.pitt.edu/ mailto:michelle.brear@wits.ac.za Brear, Nkovana, and Manderson | 2 Vol 46 No 1 (2025) ISSN 2374-2267 (online) DOI 10.5195/aa.2025.544 http://anthro-age.pitt.edu progressive symptoms of cognitive decline that characterize dementia impact on quality of life and health, including by interrupting relationships and increasing social exclusion (Motta-Ochoa et al. 2021). Cognitive decline or memory loss often occurs without a dementia diagnosis, especially in resource-constrained settings. Nonetheless, literature on research conducted amongst people with a dementia diagnosis is instructive. In this section we review some of this literature and present key concepts relating to identity-making practices in people with dementia, with a specific focus on identity-making practices that involve interactions with familiar objects. Dementia has historically been equated with a loss of identity because the ability to think and reflect has been considered the basis for agency, selfhood, and individuality (Kontos 2004, 2005). More recently, the ways in which people with dementia and other chronic diseases continuously make and remake their identities, and distinguish themselves from others through actions and interactions with people and objects, has been highlighted by scholars thinking with practice and materialities theories (Lee and Bartlett 2021). Resulting concepts such as “embodied selfhood” (Kontos 2005) and “material citizenship” (Lee and Bartlett 2021) have profound implications for understanding the identity of people with memory problems, whether or not they are diagnosed as dementia. In different ways, these concepts all articulate the capacity of people with memory problems to think, feel, act, and interact in identity-expressing ways (Kontos and Martin 2013). “Embodied selfhood” (Kontos 2005) draws attention to the body’s innate capacities (e.g. to coordinate movements) (Merleau-Ponty and Smith 1962) and sociocultural dispositions (Bourdieu 1990). Together these give rise to identity-making practices, including in people with dementia (Kontos 2004). Embodied selfhood comceptualizes identity as something that is ‘embodied’. This can advance our understanding of how people with dementia maintain long-held and generate new identities through practice. This is always relational: it inevitably involves interactions with other people and with “things” (Bourdieu 1990; Ward et al. 2023). Embodied selfhood radically shifts thinking about identity away from what people with dementia forget to how they maintain identities through practices (Kontos and Martin 2013; Lee and Bartlett 2021; Mitchell et al. 2020). For example, people, including those with dementia, make and remake their identities by engaging with familiar, functional objects found in their everyday environments, in ways that extend their relationships with other people (Latimer and Munro 2009; Lee and Bartlett 2021). Materiality studies focus on processes through which inanimate objects shape relations between people, rather than exclusively on “material ‘things’ [which] never act in isolation but are interactive” (Buse et al. 2018, 252). Much has been learned about dementia from studying familiar objects involved in daily routines (Buse et al. 2018) such as clothing, dirty dishes, jewellery, and sanitation products, and how people’s interactions with these shape identities (Araujo et al. 2020; Buse et al. 2018; Buse and Twigg 2018; Kontos 2004; Lee and Bartlett 2021). For example, adult diapers, used to manage and avoid the risks of everyday incontinence, shape social relations. People resist their use, because this undermines their autonomy as they become identifyied as people incontinent or otherwise lacking control (Araujo et al. 2020; Latimer 2018). Adult diapers and other objects become points of social conflict known as “contested territories” (Clarke et al. 2010). Space, alongside the availability and arrangement of objects, influences interactions and practices. Familiar material objects provide people with opportunities to make and remake relations with others, as they identify themselves in particular ways. Mementos and televisions can personalize spaces and help older people become “at home” in new places such as rooms in a care facility (Lovatt 2018) , while functional objects such as kettles and cleaning devices in care facilities enable identity-making practices, such as preparing a visitor a cup of tea or cleaning in anticipation of their arrival (Buse et al. 2018; Cruise and Lashewicz 2022; Lee and Bartlett 2021; Lovatt 2018). Making available objects that enable identity making practices may confer the “dignity of identity” to people with dementia (Cruise and Lashewicz http://anthro-age.pitt.edu/ Brear, Nkovana, and Manderson | 3 Vol 46 No 1 (2025) ISSN 2374-2267 (online) DOI 10.5195/aa.2025.544 http://anthro-age.pitt.edu 2022, 1233). Similarly, in the familiar home, women with cognitive decline speak of keeping themselves occupied with activities such as knitting and gardening, which rely on object interactions. Such occupations are a strategy both for coping with and resisting the changes catalysed by cognitive decline; these are often practices that women see, or have experienced, as shaping their gendered identities (Tolhurst, et al. 2023). Lee and Bartlett (2021, 1471) argue that access to functional objects is the means to “material citizenship,” enabling people with dementia to participate socially. Enabling people with dementia to keep and use objects of their choosing is thus an important act of care, be it in the domestic home environment or care facility. For example, since choosing and wearing clothes is an expression of identity, it is an act of care to support people with dementia to choose and wear what they want (Buse and Twigg 2018). So too is supporting people to carry out everyday practices such as cooking and cleaning, which involve interactions with objects (food, utensils, cleaning products) and allow people to express identities (Buse et al. 2018; Lee and Bartlett 2021). Interacting with functional objects enhances wellbeing and actualizes identity (Kontos and Martin 2013) as well as citizenship (Lee and Bartlett 2021). It enables what Gelya Frank (2010) terms “occupation”— enjoyable, meaningful and productive activities suited to a person’s capacities and needs. Performing an occupation is inherently practical. It relies on using the body and mind to continually observe, plan, and use functional objects for specific purposes (Frank 2010). Seeking out, keeping, and using objects can be thought of as “dwelling” (Latimer and Munro 2009) – the art of truly living rather than merely existing. At the heart of dwelling lies relational extension, that is, “creating worlds that bind” (Latimer and Munro 2009, 317). Making room for, keeping, and interacting with objects is central to dwelling, which always involves thinking, but not necessarily in the self-reflective, contemplative manner valorized by modernists. Rather, in dwelling, thinking is practically focused on what objects one needs to make room for, and how these can be used to create worlds that bind. Although dwelling always takes place in a specific locale, it is not tied to a fixed abode. It “takes place in terms of relations” (Latimer and Munro 2009, 328). Purposive practices facilitate the formation and extension of relationships with other people and with “homely” spaces. The study we report herein explores how two women receiving informal, home-based care, because of memory loss and related symptoms, interacted with familiar objects, and how this facilitated identity- and relationship-making. Methods Our mixed-method study on the complexity of informal, home-based caregiving for people with dementia (Manderson et al. 2022) was called Kaya (meaning ‘home’ in Xitsonga, an official South African language spoken widely in the study area and by a minority – five percent – of the national population). It included a survey and an ethnography, and was nested within a broader study of dementia1. Herein we report the results of the ethnography. The study received approval from the University of the Witwatersrand Human Research Ethics Committee (M200373), and the Mpumalanga Province Health Department – Health Research Committee (MP_202201_004). Research context The analysis presented herein draws on data from a study that aimed to determine who provided care to older people with varying degrees of cognitive decline in rural South Africa, and what their caregiving entailed. It focused on how caregivers mediated the interactions of care recipients with familiar objects in home settings. The study took place in five villages in north-eastern Mpumalanga, South Africa, in an area formerly part of Gazankulu — a Bantustan or self-governing, ethnically segregated territory created during apartheid. Like other former Bantustans, Gazankulu was a subsistence farming area where growing fruit, maize, and legume crops was central to social life. Yet http://anthro-age.pitt.edu/ Brear, Nkovana, and Manderson | 4 Vol 46 No 1 (2025) ISSN 2374-2267 (online) DOI 10.5195/aa.2025.544 http://anthro-age.pitt.edu Gazankulu was situated on marginal lands and was developed only as much as was required to maintain social order and a compliant, migrant workforce for colonial industries such as mining and farming (Wolpe 1972). Residents of apartheid-era Bantustans were left to care for themselves, as best they could, with minimal government assistance. Since South Africa transitioned to democracy in 1994, there have been improvements such as new primary health clinics, the expansion of social security, and, for many, improved socio-economic status as measured by household asset indices (Kabudula et al. 2017). However, nearly 60 percent of the population nationally live on or below the poverty line, housing is often crude, unemployment rates are high, and in much of the country, services such as water, waste management, sanitation, and transport are absent or inadequate. This is true in the area in which our research was conducted. Participants and sampling We studied two women with memory problems, Rhandzu and Nonisa, with the consent of their caregivers (respectively Xisthembiso and Rhulani) (all pseudonyms). Both were identified within a broader ethnographic study about caregiving for people with dementia, involving 21 older people and their caregiving networks. Rhandzu and Nonisa were selected as the focus of this analysis, because they were reported by members of their caregiving networks, and observed by authors Michelle Brear and Themby Nkovana, to require care because of symptoms consistent with cognitive decline. Among other things, they consistently forgot the names, faces, and/or deaths of close family members, were at times agitated or distressed, and got lost in familiar places. No other people within the 21 caregiving networks we studied were reported or observed to need care because of memory problems. Despite being in need of care because of memory problems, caregiving involved interdependency and bi- directionality (Milligan and Wiles 2010). Nonisa, Rhandzu, Rhulani and Xistembiso all gave and received care to different people at different times. In this article we draw on Michelle’s and Themby’s participant observation with Nonisa and Rhulani, and Rhandzu and Xisthembiso, as well as with people in their caregiving networks. During these interactions we communicated almost exclusively in Xitsonga, which is Themby’s mother tongue, and which she translated in real time, for Michelle. Over a period of ten consecutive months, we spent time with Nonisa and Rhulani, and with Xisthembiso and Rhandzu in their homes and during outings, detailing our interactions with them in fieldnotes. We also conducted and recorded one interview with Xishembiso (44-minutes) and one with Rhulani (90-minutes). Both were translated and transcribed afterwards. In this analysis we focus on segments of the data that described how Rhandzu and Nonisa interacted with inanimate objects, how Xisthembiso, Rhulani and other people in the caregiving networks influenced these object interactions, and how Rhandzu’s and Nonisa’s practices and identities were consequently shaped. Data analysis During several readings of the datasets, Michelle coded data for easy retrieval and further consideration of Rhandzu’s and Nonisa’s interactions with inanimate objects. She considered the meaning of the data in relation to dwelling (Latimer and Munro 2009) and other theoretical concepts introduced above (relational extension [Latimer and Munro 2009], embodied selfhood [Kontos 2005], material citizenship [Lee and Bartlett 2021] and contested territories [Clarke et al. 2010]). She wrote summary narratives about how object interactions influenced Rhandzu, Nonisa and people in their caregiving networks, in terms of their practices, identities, and sense of place. Rhandzu: Homemaking through familiar domestic object interactions Rhandzu (72 years) lived with Xisthembiso (69 years), her younger sister and primary caregiver. Rhandzu had never married nor borne children. During Apartheid, she cleaned white people’s homes, http://anthro-age.pitt.edu/ Brear, Nkovana, and Manderson | 5 Vol 46 No 1 (2025) ISSN 2374-2267 (online) DOI 10.5195/aa.2025.544 http://anthro-age.pitt.edu washed their clothes, raised their children, and picked fruit and other crops for white farmers, and she had built her house with these earnings. The house was relatively large, with three bedrooms and a separate dining and sitting room. It was expensively furnished by local standards – the kitchen had fitted taps (whereas most households in the area relied on outdoor taps) and cupboards, and included a refrigerator and four-plate stove; the sitting room housed a leather recliner suite; and the bedroom furniture was solid wood. It was set in a large, fenced yard, with around 20 mango and avocado trees, clusters of banana and cassava plants, and fields to grow both maize and peanuts in the rainy season. In April 2022, Xisthembiso had left her own home eight kilometers away, which she had shared with her husband until his death in 2013, to live with and provide constant care for Rhandzu, after receiving a call from a neighbor who expressed concern for Rhandzu. Upon arrival, Xisthembiso found that Rhandzu was acting strangely – hallucinating, walking around the house singing and dancing, and calling out for dead relatives. She showed little interest in eating and had lost weight. Rhandzu had burnt most of her stockpiled firewood and, Xisthembiso suspected, other objects such as clothes and blankets; many of Rhandzu’s clothes were missing from the house when Xisthembiso arrived. Rhandzu showed little interest in dressing up in what remaining clothes there were, although sometimes she would add a not-quite-matching hat or a belt to an outfit Xisthembiso had prepared for her. But she loved “playing” with clothes, to use Xisthembiso’s term to describe what she considered Rhandzu’s inappropriate (and therefore contested) use of material objects. And because Rhandzu’s playing had consequences, Xistembiso sometimes intervened to stop it. For example, she started hiding the matches after finding scraps of fabric from her (Xistembiso’s) favorite dress in the ashes of a fire. She started locking her wardrobe after Rhandzu had swapped the clothing around: Xisthembiso’s clothes were in Rhandzu’s wardrobe and Rhandzu’s clothes were in Xisthembiso’s. On another occasion, Xisthembiso returned from an outing to find her wardrobe empty and her clothes outside in basins, waiting to be (unnecessarily) washed. Although controlling material objects such as wardrobe keys and matches protected the clothing and Rhandzu from harm, it prevented Rhandzu interacting with the clothing, in ways that had meaning (even if only Rhandzu understood it) and occupied her. New interactions with familiar meal-time objects By the time we met the sisters in October 2022, Rhandzu appeared to have settled in to having her sister live in and care for her. Although she sometimes performed the caregiver role (as in one introductory vignette, which details her pouring water from a jug and finding a towel, to facilitate us washing our hands), she usually appeared comfortable with, and to enjoy, interacting with familiar mealtime objects in new ways, through which she performed the role of care recipient. The time she sat on the couch and waited for Xisthembiso to serve mahinyahinya (described in the other opening vignette) is one example. Another day we watched as Rhandzu dipped her hands in a plastic dish of warm soapy water which Xisthembiso was holding for her. She scooped up water in one hand and poured it over her other hand. She dipped both hands in the water and rubbed them together, then cupped and scooped the water again. It seemed like she might occupy herself in this way for hours. Xisthembiso told her to finish up, but Rhandzu continued “playing” with the water. When Xisthembiso attempted to remove the dish, Rhandzu grabbed its edge, and the sisters struggled over the dish. Familiar objects – a dish and water – became a source of conflict, a “contested territory” (Clarke et al. 2010), marking the threshold between Rhandzu’s desire to act out her identity as care recipient by “playing” and Xisthembiso’s surveillance to ensure Rhandzu ate. After meals, Rhandzu would typically wait for Xisthembiso to take her plate and bring more water for more handwashing. But, once in a while, she would become restless and stand up and start clearing the plates away herself. After taking the plates to the kitchen, she might come back and wipe the table with a cloth, barely acknowledging us, as if we were strangers rather than friends with whom she had just shared a meal. In doing so, she occupied herself while perfoming in ways consistent with the http://anthro-age.pitt.edu/ Brear, Nkovana, and Manderson | 6 Vol 46 No 1 (2025) ISSN 2374-2267 (online) DOI 10.5195/aa.2025.544 http://anthro-age.pitt.edu gendered norms of domestic work or homemaking, occupations she had performed both as paid worker and homemaker throughout her life. As for women with cognitive impairment in Hellström, Eriksson, and Sandberg’s (2015) study, doing housework enabled Rhandzu to perform gendered work and resist the loss of autonomy associated with her memory problems. Pre-occupation with domestic objects It was disconcerting when Rhandzu was ever-so-politely aloof and more interested in interacting with domestic objects than with us, because she was usually extremely affectionate. Often when we arrived she would smile, stare, and tell us how beautiful we were. She would want to hold hands, sit close, play with Michelle’s hair, and eat or drink with us. She would offer us things or worry that she had not fed us. Even though she could not remember who we were, she interacted with us, and often also interacted with familiar objects in ways that constituted dwelling (Latimer and Munroe 2009), because they extended our relations and bonds with each other. But Rhandzu could quickly shift from being affectionate to being withdrawn or indifferent. At these times she often did not recognise and was not interested in interacting with us or with Xisthembiso . She would become preoccupied with using familiar domestic objects such as washing basins and rags to clean. Although Rhandzu could no longer clean with the degree of competence Xisthembiso expected, we witnessed how performing domestic rituals kept her busy and contented her (Frank 2010) at times when she was not interested in interacting with people. One Friday when we visited Xisthembiso and Rhandzu, we cooked tihovu (a dish of maize, peas, and peanuts) outside over a fire. Rhandzu took a nap shortly after we arrived. On waking, she rushed outside to wash the underwear she had wet in her sleep. She was frequently incontinent and always washed her underwear herself. Doing so was another way by which she exerted her agency and competence as she performed the gendered identity of homemaker, which has been noted as an important identity for women experiencing cognitive decline in other settings (Hellström, Eriksson, and Sandberg 2015). When Rhandzu finished washing and had hung her underpants to dry, we asked her to come and sit with us. She refused. For hours, she wandered around the yard. Sometimes she carried a rake. She stood near the water containers that Xisthembiso had filled on Wednesday, the only day the tap ran. Rhandzu poured water into plastic and metal basins filled with dirty dishes or clothes, occasionally removing an item and hanging it on the clothesline. As Rhandzu started pouring water again, Xisthembiso shouted at her to leave the water alone, before turning to us, smiling, and telling us that she had to speak like that to make her sister listen. Rhandzu stopped, but minutes later was back, pouring water from the buckets again, this time for bathing her body. Xistembiso let Rhadzu go, although she was concerned about running out of water. Although “playing with water” posed no direct harm to Rhandzu, the 500 liters Xisthembiso stored in buckets had to last from one Wednesday to the next. Xisthembiso conferred on Rhandzu the dignity of her chosen identity, seeing no harm in letting her “play” when there was enough water. But physical caregiving was not possible when water ran out, and so water was a precious resource. Perhaps because dirt objectified neglect and the possibilities for physical health problems, Xisthembiso sometimes tried to deny Rhandzu the opportunity to “play” with water (i.e. use it for purposes that she did not see as essential). As a result of its scarcity, water became a “contested territory” (Clarke et al. 2010). Caregiving through interactions with familiar objects Rhandzu expressed interest in caring for others, and enacting a caregiver identity invariably involved her giving, preparing or otherwise interacting with objects. One summer day, Xisthembiso offered to http://anthro-age.pitt.edu/ Brear, Nkovana, and Manderson | 7 Vol 46 No 1 (2025) ISSN 2374-2267 (online) DOI 10.5195/aa.2025.544 http://anthro-age.pitt.edu pick us mangoes from Rhandzu’s trees. As Xistembiso found a 20 liter bucket in which to pack the mangoes, Rhandzu went to the kitchen. She took a metal dish, flicked the water in the bottom of it outside onto the dirt, then walked hurriedly to where Xisthembiso and Themby stood under the trees, using a long, thin stick to bang the mangoes off the branches, picking them up and putting them in the bucket as they fell to the ground. When Rhandzu reached the trees, she started picking up mangoes — some just fallen, others lying rotting on the ground — and placed them in the dish. She bent over, picked up a twig, and reached it towards the mangoes on the trees’ lowest branches. The twig broke whenever Rhandzu hit a mango, and she then looked for another on the ground. She stayed under the trees thrusting the twigs at the low hanging fruit long after Xisthembiso and Themby had filled a 20- liter bucket with mangoes. She smiled as she worked. When we called her to come over and wash her hands with us, she insisted she was still busy. Although she did not perform the familiar task of harvesting mangoes with much competence, it was an occupation she clearly valued, seemingly because it enabled her to care for us by giving us food. Rhandzu could occupy herself for hours shelling peanuts that had grown in her fields the previous season and were stored in her garage. Rhandzu often drifted to sleep about 15 minutes after we sat down to chat, but when she had a bowl of peanuts on her lap, she would stay awake, scooping a handful of unshelled nuts using her left hand, then shifting them to her right hand one nut at a time, and squeezing her fingers to open the pod. Once broken, pods and nuts were tossed into a second bowl later to be separated before grinding, cooking or planting, although Rhandzu would also eat the raw peanuts as she worked. Another day, we watched her shelling peanuts with a group of female relatives (sisters- and daughters-in-law) at a sick stepbrother’s homestead. The other women broke open the pods and tossed them into a flat, round, woven basket (rihlelo in Xitsonga). Rhandzu added a few nuts to the basket but mostly ate those she shelled, as the women reminisced fondly about the stylish clothes Rhandzu used to wear, and the daring adventures she would undertake when she was working. Occupied with the peanuts, as in the examples describe above, Rhandzu remained alert and participated actively in the social gathering, renewing bonds with relatives she rarely saw due to her mobility and transport challenges. When she went out, Xisthembiso worried about Rhandzu playing with and using up all the stored water or packing her bags and trying to leave. On several occasions she had woken up or come home from an essential outing to find Rhandzu waiting by the locked gate to her yard with bags of packed goods she wanted to take “home” with her. Xistembiso started leaving Rhandzu with peanuts to shell while she was out. She was pleased to discover that when Rhandzu had a bowl of peanuts to shell, she did not play with the water nor pack her bags and try to leave. Xisthembiso had started locking the gate after Rhandzu walked out of the yard to the local shop looking for children that she believed were missing, then returned via houses along the way, asking if people had seen them. Although Rhandzu’s movement should not be thought of as wandering — she demonstrated a clear purpose — her temporary disappearance was very distressing for Xisthembiso. Xisthembiso consequently bought a padlock to secure the gate to prevent Rhandzu walking out again, afraid that some harm might come to her. But one morning Xisthembiso woke at 4am to find the keys to the padlock missing. Rhandzu had “stolen” them, unlocked the gate, and walked out again. She arrived hours later at her brother Sergi’s house, some three kilometers away. Like water and other familiar objects, the padlock and keys became contested territories (Clarke et al. 2010). Nonisa: Homemaking with familiar outdoor objects Nonisa (59 years) lived in a large, decrepit house with her daughter, Praises, and several grandchildren, a ten-minute walk away from Rhulani, her 92-year-old father-in-law’s house. Nonisa and Rhulani saw each other most days. They cared for and received care from each other, and kept each other company. For example, since Nonisa’s husband, Rhulani’s firstborn son, had passed away many years before, http://anthro-age.pitt.edu/ Brear, Nkovana, and Manderson | 8 Vol 46 No 1 (2025) ISSN 2374-2267 (online) DOI 10.5195/aa.2025.544 http://anthro-age.pitt.edu Rhulani had cared for Nonisa and her children financially, providing food and other essentials. Nonisa helped Rhulani, whose wife had died a year earlier, with cooking, cleaning and maintaining his yard. Rhulani would carry meat over to Nonisa’s house and ask her to cook it over a fire in her outdoor kitchen, so that they could eat together in her large yard, which was surrounded by fields in which she grew crops during the raining season. The yard was an extension of her home; we invariably found her outdoors when we visited. She never invited us indoors – we always sat in the neatly swept yard under one of numerous trees. Although Nonisa grumbled that her grandchildren never helped her sweep, she seemed to take pride in the yard’s neat appearance, and keep herself occupied sweeping it. Several times when we visited, we found her outside, her torso bent at 90 degrees, one arm resting on her back while she swished the stick broom, leaving patterns in the soil. Nonisa told us she walked for ten minutes or so through the neighborhood to visit Rhulani every day. She helped him with domestic chores and swept his yard, although he could still do most things himself, and an adult grandson lived with him to help with physical work. When we visited Rhulani’s home with Nonisa, she would haul open the gate without shouting tamanini (literally meaning “at home” – the equivalent of hello or knocking on the door) to announce her arrival, as expected of a visitor. She would leave us on the stoep (verandah) while she went indoors to fetch plastic chairs for us to sit on. She might call Rhulani’s name when she got inside. Rhulani’s grandson entered the house in a similar manner, but everyone else called from the stoep or entrance to the yard. Nonisa performed her role as daughter-in-law, who would typically be expected to treat her in-law’s home as her own and perform domestic duties within it, by the way she navigated the space and interacted with familiar objects within it. Like Rhandzu, she was performing a gendered role that was central to her identity, and exerting autonomy, as she cared for us as visitors and interacted with objects such as the gate and plastic chairs. Imagining and reminiscing with familiar objects At first, we missed Nonisa’s memory problems, partly because Rhulani was the one categorized as having mild cognitive decline within the broader dementia study in which our ethnography was nested1. Yet as we got to know her, Nonisa’s memory problems materialized in the inconsistent stories she told, particularly about her husband. Nonisa frequently talked about her husband and the cars he bought her. She spoke of driving to the city (in the very recent past) to visit him, in a Toyota Sedan that he had given her, noting how lucky she was to have a husband who did not expect her to stay at home all of the time. She told us about driving another vehicle, a bakkie (pick-up truck) that her husband had given her, to buy and transport oranges from a distant town to sell locally for a small profit, and to collect firewood she had cut in the forest or gather water from distant sources when none was available locally. She told us how she shouted at the children for playing with the car, which she said was parked in the garage. We never saw the cars and wondered how she drove them out of the garage and past a grave which was built in front of it – a grave which we later found out was Nonisa’s husbands’ grave. Rhulani told us that his first-born son (Nonisa’s husband) had died in a car accident years before, around the time Nonisa started having memory problems. As his wife, Nonisa had inherited three cars from him, which she previously drove around the village. But they broke down not long after her husband’s death, never to be repaired. Even so, through the stories she told about her late husband and the cars, Nonisa identified herself in a gendered way, as a fortunate wife with a caring husband. Nonisa only spoke to us of her husband being dead once. We were sitting outdoors on plastic chairs under a tree while her grandsons were kicking a soccer ball. When the ball smacked the headstone of the grave in front of the garage, Nonisa laughed and told us the boys were remembering their http://anthro-age.pitt.edu/ Brear, Nkovana, and Manderson | 9 Vol 46 No 1 (2025) ISSN 2374-2267 (online) DOI 10.5195/aa.2025.544 http://anthro-age.pitt.edu grandfather. “Your husband?” we asked. “When did he die?” Nonisa thought it was the previous year (2021) but suggested that we check the date engraved on the headstone. It showed that he had died in 2006; Nonisa had been a widow for more than 15 years. The tombstone provided a visual and material reminder to Nonisa of her husband’s death, and subsequently her identity as a widow. Producing and giving food From the gravestone, Nonisa took us on a tour of the yard. She wanted to show us the fruit trees she had planted, in the hope that her grandchildren would not steal fruit from other people’s trees. If they did, she explained, people would gossip about her. The problem was the cars, she told us. People knew her husband had given her cars and would wonder why her children begged for fruit when their mother had a car. She had no recollection of having shown us the trees on previous visits. She told us about each tree — one that bore wonderfully sweet oranges, an apple that no longer bore fruit; guavas affected by drought; a peach tree she liked to sit under — and several times she repeated that she had planted the citrus trees — seven including mandarins, oranges and grapefruits — so that her children would not steal or beg. Like Rhandzu, Nonisa identified herself as a caregiver and food provider, and reinforced this through the stories she told about her trees and what they meant to her. Nonisa also produced other food, ploughing her field with maize, peanuts, and vegetables in the rainy season and helping Rhulani plough and harvest the fields that surrounded his yard. One November morning we arrived to find her at the bottom of the field, wearing a broad, brimmed hat and wielding a hoe to clear the weeds. She dropped the hoe and walked over to greet us, as we walked towards her. After she had pointed out the okra, sweet potatoes, peanuts, and other crops, Michelle asked her if she would prefer us to come back some other time, so as not to disturb her work. No, she replied. She was just keeping herself busy in the field and it was now getting hot. The agricultural work could wait; she wanted to sit and chat with us. The trees in Nonisa’s yard and the fruits they bore, the agricultural routines of planting and harvesting required to make food available, created relations and a sense of homeliness, affirming Nonisa’s role as caregiver. The trees enabled her to remember the past (even if she confused it with the present) and anticipate a future, in which she expressed her identity as a wife and mother who cared for her family by feeding them well. Walking out to collect firewood Apart from sweeping the yard and farming, Nonisa’s other routine occupation was collecting firewood to use for cooking and heating water in her outdoor kitchen. She would go to the forest to cut wood and in doing so, she expressed identity as she enacted the gendered role of wife and caregiver. During the course of our study, she told Rhulani and others that she used the firewood to heat water and cook for her husband. Nonisa’s interaction with real firewood and imagined cars was a way of anticipating a positive — homely — future (Buse et al. 2018), albeit one she could never actualize. Nonisa’s practices, and the imaginings of her husband that underpinned them, seemed to force back out of her home the post-apartheid world with its “unrepresented pasts that haunt[ed] the … present” (Bhabha, 2002, 373), which had made the house “unhomely” (not to feel like home). Nonisa’s house was haunted with legacies of apartheid that presented themselves as everyday forms of structural violence — poverty, food deprivation, premature death. Reminiscences about the cars, and driving to and caring for her husband, may have been an emotional retreat from an unhomely space (Capstick and Ludwin 2015) to a place in which her husband was absent but alive. At the same time, the extent to which Nonisa felt at home in her home and its surrounds, seemed to fluctuate. Left to her own devices, Nonisa would walk into the forest, carrying a panga knife to lop branches; sometimes she was accompanied by her children or grandchildren, other times not. Rhulani, however, http://anthro-age.pitt.edu/ Brear, Nkovana, and Manderson | 10 Vol 46 No 1 (2025) ISSN 2374-2267 (online) DOI 10.5195/aa.2025.544 http://anthro-age.pitt.edu encouraged the children to dissuade her from going there, and to lock the gate so that she could not follow them into the forest or elsewhere, and get lost, as she had done several times. Rhulani and other family members had to scour the forest looking for her, and he worried that one day Nonisa would go missing or encounter harm before they found her. He reprimanded the children when they did not lock the gate. But locking the gate limited Nonisa’s ability to practice her chosen identity and make her home homely. Homi Bhabha (2002, 378), in his postcolonial reading of some of the great houses of 21st century fiction, argues that the private space of the home is made unhomely by “the world forcibly entering” in violent and disorienting ways. Padlocks, familiar objects used by caregivers to restrict movement, caused disorientation because they changed the meaning of homes and made houses unhomely. Padlocks became “contested territories” (Clarke et al. 2010), as adult diapers did in Araujo et al.’s (2020) study, because of the different meanings they held for people with memory problems and those providing care to them (Lovatt 2018). The familiar objects also modified familiar spaces, and the relations that made them homely, in ways that conflicted with Rhandzu’s and Nonisa’s dispositions. This was epitomized by Rhandzu “stealing” the keys. Rhandzu and Nonisa did not want to be locked in, even for their own safety if they had seen it in this light; the locks on the gates took from them the freedom to come and go as they pleased and stripped them of agency; they made their homes unhomely. Rhandzu expressed her identity as an independent woman, both by resisting being locked in and by planning the means to escape — locating the keys and using them to release the padlock while her sister slept. Nonisa also exerted her agency when she walked out to the forest, when her grandchildren forgot to lock the gate. Despite Rhulani’s requests, Nonisa’s grandchildren seemed reluctant to reverse the social power hierarchy they were predisposed to (Bourdieu, 1990) and to start locking their grandmother in, restricting her movement to the safe space of the yard. These acts of surveillance and restriction changed the meaning of home (Campbell et al. 2023) and the familiar objects kept within it (Latimer and Munro 2009; Clarke et al. 2010). Padlocks and gates were contested partly because both women felt at home, in neighborhood spaces, outside their private dwellings and yards. Campbell et al. (2023) have noted that the spaces that people with dementia considered home extended to outdoor areas such as gardens and balconies. For Rhandzu, as for most South African women, domestic routines such as handwashing dishes and plates, as well as agricultural work, were performed outdoors. The spaces in which Nonisa felt at home extended beyond the home-yard to Rhulani’s house and yard, and the forest and the paths through the village that connected all these places. For both women, walking out of the home-yard was an act of dwelling in that it connected them to, and extended their relationships with, people in their neighborhoods. Walking out may have been an act of resistance to isolation and diminishing autonomy and a means to actualising citizenship (Lee and Bartlett 2021) by extending binding relationships and making homely, physical spaces outside their home and yards. Discussion For Rhandzu and Nonisa, dwelling relied on “embodied selfhood” (Kontos 2005), the socio-cultural dispositions and knowledge required to use familiar objects in practical ways. It made the domestic spaces in which Nonisa and Rhandzu were cared for feel like home (Bhabha 2002) and allowed them to practice dwelling (Latimer and Munro 2009). At the same time these familiar objects sometimes became sources of social conflict or “contested territories” (Clarke et al. 2010). Conflict occurred when Rhulani and Xisthembiso restricted access to such objects, or used them to restrict Nonisa’s or Rhandzu’s movement. Latimer and Munro (2009) conceptualize home as potentially any social space where people “keep” objects that enable relational extension — “creating and reproducing worlds that bind” (317) — and dwelling a practice that takes place “as and whenever relations are formed in the here and now” (Latimer and Munro 2009, 318). From this perspective, relationships are constantly shaped — along http://anthro-age.pitt.edu/ Brear, Nkovana, and Manderson | 11 Vol 46 No 1 (2025) ISSN 2374-2267 (online) DOI 10.5195/aa.2025.544 http://anthro-age.pitt.edu with identities and homes — through the consumption and disposal (and our findings indicate also production) of objects. Home or place is not tied to a specific location, but defined by processes, involving interactions with familiar objects, through which people bind themselves to others and create a sense of belonging and feeling “at home” in a particular locale (Latimer and Munro 2009). The relational extension at the heart of dwelling often involves habitual interactions with familiar, everyday objects to perform routines (Latimer and Munro 2009). Spaces come to feel homely, because they are the sites of banal domestic activities, including the “survival rituals of food” (Bhabha 2002, 375) that are so fundamental to health and relationships. Both Rhandzu and Nonisa interacted with material objects (especially food, but also clothes, water for washing, firewood) in their performances of gendered caregiver roles. Caregiving is quintessentially women’s work and doing caregiving work has been identified as maintaining and remaking the gendered identity of women with cognitive decline in other settings (Boyle 2013; Hellström, Eriksson, and Sandberg 2015). Doing caregiving is also a way in which women with cognitive decline balance their needs for care with their needs to maintain dignity and agency (Brownlie and Spandler 2018). Giving food also enabled reciprocity and social participation (Motta-Ochoa et al. 2021). Rhandzu and Nonisa engaged primarily with familiar objects that characterize rural South African domestic spaces and with the gendered routines that make these spaces homely — fruit trees and their produce, hand-cut firewood, raw peanuts, water, and laundry. These are very different to the objects prominently identified in research in residential care settings — jewellery, clothes, sofas, photographs and other mementos, televisions and clocks (Kontos 2005; Lee and Bartlett 2021; Lovatt 2018) and private homes (Campbell et al. 2023) in high-income countries. The gendered practices of “making home” in rural South Africa were quite different from and thus relied on different functional objects to those reported in high income countries. For example, gardening work was primarily focused on food production, a type of gardening which has been characterized as being done by men in the United Kingdom (Buse, Balmer, Keady, Nettleton, and Swift 2024). Interacting with objects familiar in their context facilitated Rhandzu’s and Nonisa’s social participation and citizenship, enabling the women to identify themselves in culturally specific, classed and gendered ways (Kontos 2004; Lee and Bartlett 2021; Tolhurst, et al. 2023). Scarce objects (water, food) and those used to restrict Rhandzu’s and Nonisa’s autonomy (gates, padlock) were sources of social conflict. These “contested territories” (Clarke et al. 2010) demonstrate the competing agendas and moral dilemmas involved in caregiving for a person with memory problems in a context that was precarious because of material scarcity (Latimer 2018). The right course of action was far from clear for Rhulani and Xisthembiso, who were giving care needed because of memory problems, needed to balance Nonisa’s and Rhandzu’s emotional needs for occupation, with the physical risks that this sometimes entailed. Practices such as “playing” with water and collecting firewood, that helped create positive identities, psychological wellbeing, and a sense of citizenship (Lee and Bartlett 2021) for Nonisa and Rhandzu, involved physical health risks that their caregivers could not ignore. Xisthembiso and Rhulani controlled access to everyday objects such as water, firewood and gates, denying Rhandzu and Nonisa the autonomy so fundamental to citizenship (Buse et al. 2018), in order to manage their precarious environments. Policy and practice implications Our findings highlight an urgent need for extending and maintaining basic infrastructure to supply water in rural South Africa, if informal, home-based caregivers of people with memory problems are to be supported in ensuring the health of those for whom they care and in enabling people with memory problems to interact with chosen objects. This may be particularly significant when the person with memory problems is a woman, because the performance of gendered practices such as washing and http://anthro-age.pitt.edu/ Brear, Nkovana, and Manderson | 12 Vol 46 No 1 (2025) ISSN 2374-2267 (online) DOI 10.5195/aa.2025.544 http://anthro-age.pitt.edu cleaning rely on the use of water. This also highlights the need for gender-sensitive policies and programs to support people with cognitive decline and their caregivers. We also highlight the importance of policies, programs and individual caregivers of people with memory problems, being sensitive to the importance of object interactions that keep people with memory problems occupied and enable them to extend relationships with others. People who take on the responsibility of providing care needed because of cognitive decline, may understandably prioritize physical safety, for example preventing the person they are caring for getting lost, or ensuring water does not run out. Yet they may not be consciously aware of how interacting with objects can enable people with cognitive decline to do things that express their agency or identity, and that are important for maintaining dignity and wellbeing. Policies guiding the provision of informal, home-based care may also be strengthened by acknowledging the potential for conflict in caregiving relationships, including conflict that arises over the certain uses of familiar material objects. Limitations Our analysis is limited to two women’s cases, and thus is not definitive and cannot be generalized. Nonetheless, Nonisa and Rhandzu provide us with important insights about how women with cognitive decline in rural South Africa interact with familiar objects. These two cases show how the women kept and used familiar objects and maintained familiar activities to express their (gendered, classed) identities, and how these objects and actions formed and extended their relationships, and made the homes in which they aged and received care “homely.” Because our study was focused on informal home-based caregiving, we did not set out to collect data on object interactions. We did so when object interactions seemed to be important parts of caregiving and thus we may not have captured all of the ways in which the women interacted with objects. The prominence of object interactions became apparent when reading the data and prompted this analysis, which we believe provides unique insights about dwelling – keeping and interacting with objects in ways that form and extend relationships with other people (Latimer and Munro 2009) — in a rural South African context. Conclusion Facilitating familiar object interactions is an act of care. Interactions with everyday objects enabled two South African women with cognitive decline to perform the art of dwelling: to express and make identities, relationships and homes in ways that promoted their wellbeing, in the rural, informal home- based care context of our study. The interactions we observed illuminated everyday objects of the home environment that have not been mentioned in previous studies. Rhandzu’s and Nonisa’s interactions with objects highlighted social relationships in the home, which might facilitate or act as barriers to controlling how people with cognitive decline interact with everyday objects and use them to make familiar spaces homely. Our findings suggest the importance of the cultural and gendered nature of attachment to homely places, and the processes through which homemaking takes place during aging and cognitive decline. Women whose identities are tied to homemaking, and to the homes that they create through homemaking practices, may have particular attachments that make the value and practice of aging in place gendered. We see value in future research about identity in people with cognitive decline and memory loss, adopting an explicit gender lens. With reference to the concept of “contested territories,” we have highlighted the potential for conflict in informal, home-based care for people with cognitive decline, that the introduction of material objects (e.g. padlocks) to existing social orders might provoke. In our study these included locking the gate and securing the keys, and restricting access to resources such as water that are scarce in precarious living environments. We emphasize the importance of acknowledging the potential for conflict and how to manage it in ways that still enable dwelling. http://anthro-age.pitt.edu/ Brear, Nkovana, and Manderson | 13 Vol 46 No 1 (2025) ISSN 2374-2267 (online) DOI 10.5195/aa.2025.544 http://anthro-age.pitt.edu Further research is needed to interrogate potentially multiple, geographic and process-based meanings of objects, home and place, and to understand how places of belonging, in which people with cognitive decline feel at home, can be created through dwelling in various locations, potentially including institutional care homes. We also suggest examining how interactions with objects and other people can make and are constantly needed to make a “place” homely. Policies and programs might acknowledge and address the potential for conflict to arise in informal, home-based care settings, as well as the importance of facilitating object-interactions through which people with cognitive decline make their identities, create spaces that feel like home, and promote their health. Further research will help us understand the practices through which people living with cognitive decline maintain their identities in contexts of precarity. Notes 1. The Kaya study was nested in a dementia sub-study of Health and Aging in Africa - A longitudinal study in South Africa (formerly HAALSI, recently renamed HAALSA) (Gómez-Olivé et al. 2018), generally referred to as HAALSI-Dementia. The Agincourt Demographic and Health Surveillance site (Kahn et al. 2012), which is an area within the former Gazankulu, was the population from which participants in HAALSI were identified. 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Economy and Society 1 (4): 425-456. https://doi.org/10.1080/03085147200000023 http://anthro-age.pitt.edu/ https://doi.org/10.1111/opn.12062 https://doi.org/10.1177/13634615211001707 https://doi.org/10.1111/area.12899 https://doi.org/10.1080/03085147200000023 Rhandzu: Homemaking through familiar domestic object interactions Discussion Conclusion